Day Hospital (HDJ) Care Pathway “Organ Preservation”

Parcours Hôpital de Jour (HDJ)  « Préservation d’organe »
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The “Organ Preservation” day hospital pathway is intended for patients with rectal cancer who have achieved a complete response after neoadjuvant treatment (chemotherapy and radiotherapy).

Depending on the clinical situation, this strategy may help avoid major surgery and preserve the rectum, either through local excision (a limited procedure performed under general anesthesia via a transanal approach to remove the tumor scar), or through close surveillance using a watch-and-wait strategy.

Depending on the clinical situation, this strategy may help avoid major surgery and preserve the rectum :

  • Either through local excision (a limited procedure performed under general anesthesia, using a transanal approach to remove the tumor scar),
  • Or through close surveillance using a watch-and-wait strategy

Consultation with the Surgeon

During the day hospital visit, you will meet the surgeon for a rectoscopy.

You will then be seen again after an MRI scan - performed at our institute - in order to assess all the necessary criteria :

  • Clinical response,
  • Endoscopic response,
  • Radiological response. 

The aim is to confirm the absence of any residual tumor and to validate the feasibility of an organ preservation approach.

Once all the results are available, a dedicated consultation will be arranged between you and the surgeon.

This is a key moment, allowing for an in-depth discussion of the different options, their benefits and constraints, and ensuring that your preferences are fully taken into account in the decision-making process.

The final strategy is therefore chosen within the framework of a true shared decision-making approach.


Meeting with Other Members of the Care Team

As in the surgical day hospital pathway, you will be supported by the same healthcare professionals involved in your care. Their roles include :

  • Assessing your nutritional status, which is often affected by treatments (weight loss, digestive issues),
  • Addressing potential sexual side effects of treatment and offering appropriate support,
  • Providing psychological support, as an organ preservation strategy may be associated with stress, uncertainty, or emotional burden. 

This multidisciplinary approach ensures comprehensive, coordinated, and personalized care, helping to safely implement an organ preservation strategy whenever it is appropriate.

Your Care Pathway

At the end of the consultation or during your hospitalization, the surgeon may suggest that you participate in a research protocol, such as a study evaluating a new surgical device, a new method of administering it, new surgical techniques, personalized therapeutic strategies, etc.